瘦素和血管内皮生长因子在先天性心脏病患儿中的变化

目的：探讨血清瘦素（LEP）和血管内皮生长因子(VEGF)在先天性心脏病（CHD）患儿中的变化与作用。方法：左向右分流型先心病组（非发绀组）48例（心衰组20例，无心衰组28例），右向左分流型先心病组（发绀组）20例，正常对照组20例。分别测定以上各组儿童血清LEP，VEGF和总蛋白、白蛋白浓度及体重指数（BMI）。结果：先心病患儿各组与对照组之间血清总蛋白、白蛋白浓度差异无显著性(P>0.05)，BMI差异有显著性(P<0.01)。发绀组、心衰组、无心衰组及对照组间血清LEP，LEP/BMI及VEGF浓度有明显差异(P<0.01)。与无心衰组比较，发绀组、心衰组LEP，LEP/BMI及VEGF浓度明显升高（P<0.01）。在非发绀组患儿中，心衰组和无心衰组血清LEP与BMI均呈正相关（P<0.01）。在发绀组患儿中，血清LEP与VEGF水平呈正相关（P<0.01）； 血红蛋白含量与VEGF水平呈明显的正相关（P<0.01）；动脉血氧饱和度与血清VEGF及LEP水平呈明显的负相关（P<0.01)。结论：LEP和VEGF参与CHD的病理生理过程。LEP和VEGF与非发绀型CHD的心衰发生有关。［中国当代儿科杂志，2009，11（10）：802-805］

Changes of serum leptin and vascular endothelial growth factor in children with congenital heart disease

OBJECTIVE: To study the changes of serum leptin (LEP) and vascular endothelial growth factor (VEGF) in children with congenital heart disease(CHD) and their roles in CHD. METHODS: Forty-eight children with acyanotic CHD (ACHD group), 20 age-matched children with cyanotic CHD (CCHD group) and 20 healthy children (control group) were enrolled. The ACHD group was subdivided into two groups with (n=20) or without concurrent heart failure (n=28). Serum LEP, VEGF, total protein and albumin levels and body mass index (BMI) were measured. RESULTS: Serum total protein and albumin levels were not apparently different in all CHD children from healthy controls, but there was a significant difference in the BMI between them (P<0.01). Serum LEP and VEGF levels and the ratio of LEP/BMI in all CHD children were significantly higher than those in healthy controls (P<0.01). Compared with the ACHD group without heart failure, the serum LEP and VEGF levels and the ratio of LEP/BMI in the CCHD and the ACHD with heart failure groups increased significantly (P<0.01). In the ACHD group, serum LEP level was positively correlated with BMI (P<0.01). In the CCHD group, there were positive correlations between serum LEP level and serum VEGF level (P<0.01) and between hemoglobin concentration and serum VEGF level (P<0.01). Arterial oxygen saturation was negatively correlated with serum VEGF (P<0.01) and LEP levels (P<0.01) in the CCHD group. CONCLUSIONS: Both VEGF and LEP play roles in the pathophisiological process of CHD. VEGF and LEP are associated with the development of heart failure in children with ACHD. Chin J Contemp Pediatr, 2009, 11 (10):802-805]